Benin Patient Number One: Valentine's Story

Valentine front and center; he along with the the other 2 in the center were our first 3 plastic patients.
From left to right: Prince (Romes' baby brother), Gladys, Valentine, Romes and Ali. 

Open hospital day one: As the first five patients walked into the ward I could tell that they shared many of my own feelings. We were all excited (nurses, day crew, patients and family), but at the same time we were quite nervous. Of those first patients, was a little eight year old boy named Valentine. He came with his father, Papa Valentine the rest of the ward called him. Of the two young boys admitted that day he was the more cautions. He smiled shyly as we welcomed him.

Valentine comes from a village outside Cotonou. His family is very poor, but that didn’t stop his father from making the journey to the ship in search of healing for his son. Not having the money to return home, father and son spent their nights in a local park as they waited for his appointed surgery day after screening. His journey to the ship started when playing with matches caused a house fire and burned him severely. Since then, this little one has faced many hurtles and concurred them, the first being that he survived the initial event despite not having access to the type of medical care he needed. His burns closed but he was left with many scars, the largest of which caused one of his thighs to be pulled up into his lower abdomen. Valentine was no longer able to stand up straight; he walked hunched over and with a limp. The first time I saw him during the admission process we had to get a stool for him to climb in and out of his bed as he was unable to lift his leg to climb in.

Valentine was our very first patient. He was number one on the surgery schedule that Monday morning, he even got the very first unit of blood donated by a fellow nurse and crew member. He had major surgery which took a long time to heal. He was the topic of many of our prayers that first week. Valentine had to lay flat for many days after surgery so he could heal. Papa Valentine stayed right by his side. It was a blessing to see such a loving father as he cared for his son and worried for him. Valentin was in pain. It was hard to see, even knowing that things would get better. The day Valentine was allowed out of bed for the first time was one of the happiest days on the ward. He stood with his little walker, playing a game with one of his new friends and fellow patients. What a glorious sight, but the best part about the scene was the smile that spread across his face.

Laying flat to heal after surgery. Finally a smile!

Papa Valentine & Valentine with his blood donor Liz. The crew members on the ship make up a literal walking blood bank. 

Working hard with Physical Therapy to relearn how to use his muscles. 

And Valentine has not stopped smiling since. For a long time he was the joy of the hospital. As other less invasive plastics patients came and went, Valentine remained, working hard to recover. Slowly he reached many milestones in the wards; Standing straight, walking, running, sitting, riding a tricycle, reaching and stretching high, and yes even climbing into his own bed by himself without the help of a stool. We were all excited but also sad to see Valentine discharge from the hospital because we miss his smiley face and sweet spirit. He is currently at the HOPE Center (Hospital Outpatients Extension) where he can live close by in a safe and clean environment as he continues his therapy and healing. 

Standing straight!

Not being able to bend didn't stop Valentine from having fun on deck 7 with the rest of us.

 

So happy to finally be allowed to sit again
              because it means he can ride the "moto!"

Soon Valentine will be leaving to return home to his family that he has been unable to see since his father brought him to the ship. I would love to be there when his mother sees him again for the first time, standing straight and tall once again. I get I little emotional just thinking about how that reunion will be. Papa Valentine says he is excited for Valentine’s future because now Valentine will be able to return to school. 

The first season for plastics is complete. The last plastic patients are discharging today. We’re moving from burns to bones as in its place we opened orthopedics last week. Currently, B-ward is filled with kids in cast, learning to stand on straight legs. It’s an exciting time!

Author's Note: While I am currently serving with Mercy Ships the ideas and opinions expressed here are my own. Mercy Ships has not reviewed nor do they endorse the content written within this blog. A big thank you to the photographers who shared the pictures this post contains. 

Changing the World One Person at a Time

My last entry focused on the screening process and shared about the reality of what a lack of healthcare and health professionals in the country of Benin has created, a country overrun with medical needs unheard of in the developed world. When I first came to this country I thought I had prepared myself for such needs; however, knowledge of a need and actually seeing it are very different. I was emotionally devastated by the needs here that were so much greater than the capacity we had to help. When confronted with reality, it is easy to become discouraged and think “Am I really helping? How is helping a few worth it when so many are beyond our capacity to help.” Well, let me tell you: it does make a difference. We may not be able to change the whole world, but for those individuals we are able to help, we are changing their whole world. Let me tell you about just a few of those individuals..

Please note that even though you may recognized the descriptions of patients later on via Mercy Ships or other media, I have removed names from my post to preserve patient privacy. 

          

  

             Little Bird: With both her arms splinted this tiny five year old girl resembles a bird at flight and her soft voice fills the ward with singing from time to time. This intelligent little one loves mimicking those around her and has picked up a few English worlds. Some of her favorite games are peek-a-poo, counting to five in English on our fingers, and singing head, shoulders, knees and toes.  Nurses aren’t supposed to have favorite patients, but I think this little one has a special place in many of our hearts. With her sweet spirit, tight hugs and playful nature, it’s hard not to fall head over heal in love with Little Bird. This little one is so full of joy, but her body bears the scars of a grim past. A pot of hot food and a horrible accident threatened to forever inhibit her flight. As her body attempted to heal itself with limited medical intervention her little arms became cemented to her body by scar tissue. She could not lift either of her arms at the shoulders. The scar tissue has now been cut away, and a split keeps her healing skin from forming the same restricting scars. When the splints come off this little one will begin the physical therapy she needs to regain the function of her arms and shoulders. She has her entire life ahead of her now and with her intelligence and joyful outlook on life, I expect this Little Bird to soar.

Photo Credit: Miguel Ottaviano

              

Thank you to Miguel Ottaviano, the Mercy Ships Photographer who shared this picture. Pictures are only taken when patients or parents have given written consent for pictures to be taken and shared.

               The serious one: While Little bird is easy to make smile, this little one makes the nurses work for her laugh. She also wears a splint as her arm, burned after an accident with boiling water, heals. This little five year old is feisty and strong and is protective of her new friend Little Bird. She usually has a serious expression on her face, but slowly we are finding out what makes her smile, even laugh, and when she does, it lights up the whole ward. She loves dancing, singing, stickers and playing with her new best friend. If one of our little girls is missing during the night, we can always find her in the other's bed fast asleep. This little one is a survivor. God has blessed her with a great strength that I envision helping her throughout her life.

Photo Credit: Miguel Ottaviano

Photo Credit: Miguel Ottaviano

               The man without a nose: An electrical accident severely burned this man’s face, and left him without much of his nose. He has a long way to recovery as he will require at least two surgeries. The first was to release the contracted scar above his lip and to create a skin flap on his cheek that will later be used to rebuild his nose. The man without a nose is probably one of the most gracious people I know. He understands just enough English for us to communicate about most things without a translator. He has to be in pain, but he never complains. Whenever I see him, he greets me with a smile and every time we talk, no matter how long or short the conversation may be, he shares words of blessings.  God’s grace shines through Him. He is a blessing to the ward, and I am so honored to be a part of his recovery.

              Before the hospital opened it was hard to see the difference that we would make amidst the overwhelming needs, but now I am interacting and caring for individuals. Individuals who have their entire lives ahead of them. Who have now been healed, been changed, been made whole. We may not be able to heal everyone who needs our help, but coming here, and helping those we can is still worth it. I am only making a tiny sacrifice to be here, but through this time I feel as though I have been given a better understanding of how God feels about the world, about me. Jesus came to earth offering healing also. Spiritual healing. Unlike the healing I am helping to provide, Jesus’ healing is available to all who ask for it; however, many will not accept His gift. Did God throw up His hands in despair and turn His back on humanity as a whole? No he didn’t! He still sent His only Son to heal those who would accept His gift. Jesus sees the individuals. He sees me, he sees you and that was enough for Him to give the greatest sacrifice, His life, so that we might have complete healing.

Author's Note: While I am currently serving with Mercy Ships the ideas and opinions expressed here are my own. Mercy Ships has not reviewed nor do they endorse the content written within this blog. 

Screening: the Good, the Bad and the Ugly

Roughly 1500 people lined up for the screening every day for the first week, many of whom were already outside when we arrived before dawn. Some had even spent the night.  

Desperation: that was the feeling lingering in the air. As I helped our screening team prepare the school grounds we were using as our screening center early on the first open day of screening in Benin, I learned a little more about the desperation a disparity in healthcare will create. I heard it in the shouts as the line outside the school argued and pushed, anxious to be seen, and I saw it as the Beninese police arrived to calm things down and organize a line. “Dear God,” I prayed, “please protect these people. May your peace wash over this place and still this crowd as you stilled the waters and the storm.” Thankfully Mercy Ships’ Security for the screening team had already accounted for needing police and a secure location. Nobody was injured while seeking care with us during the screening process. We were soon able to open the doors and slowly bring people in.

My first day at screening was filled with mixed emotions. I stood just inside the gate as we let prospective patients in and directed them to enter the line where they would be seen by a prescreening nurse who would determine whether they had a surgical issue within Mercy Ships’ scope of practice. Those who passed prescreening would then be directed inside the building where a more detailed health history and assessment would take place. As I smiled and greeted each patient I grew excited when I saw people we could help. Many orthopedic patients with crooked legs came through the line, including the most adorable little boy, who despite being shy came over and placed his hands in mine. I am really hoping to see this little one again on the ward, but with straight, strong legs. 

During the first day many patients passed the initial screening process and were given an appointment card for a surgeon screening during which the surgeon preforming the surgery can make the final decision whether a potential patient is a surgical candidate. The joy as these patients exited the compound radiated from them; however, for most in line, we are unable to help. In a country where there is only 0.1 physicians for every 1000 people it is not surprising that when a hospital ship comes into port people come from miles. Many of those who come do not have a health problem that can be helped via surgery. We saw patients with cerebral palsy, Downs Syndrome, strokes and so on. Many also come through the line with health problems outside our scope of practice. Most cancerous tumors are one example. Sadly, we do not have the capacity to provide chemotherapy/radiation and follow up for these patients. Removing these tumors in most cases only prolongs death and can cause additional pain. For these patients we offer palliative care assistance which consists of nursing care focused on patient comfort as well as spiritual care by hospital chaplaincy.

The other day I assisted at screening was at the end of the second week. I’m not going to sugar coat it. This was an extremely hard day for me. At this point in the screening process we had filled our orthopedic and general surgery spots. We only had space available for our plastics and maxillofacial (jaw and face) surgeries; however, we were overrun with ortho and general patients. This meant we were forced to turn away patients who had needs within our scope of practice simply because we did not have the capacity to meet their needs.

As I stood at the exit directing traffic, I was the last point of contact for the people we turned away. Most understood, but some questioned me as they left, showing me their problem as if hopping we might have misunderstood and can provide them with the care they needed after all. Saying I’m sorry, no was very difficult, but for me the hardest part was watching the ortho kids leave. I could see them coming from a distance and knew that we had been unable to accept them. It broke my heart, and the image of two of these little boys will stay in my head for a long time to come.

I realize that this is not the happiest blog post. It hurts to think about the pain others go through. It’s much happier to talk about the people we can help provide a happy ending for. Sometimes I wish that I could close my eyes to that side of the world and not feel the pain, but that isn’t the way God views the world. I was reminded later in the day by a dear friend that when we ask God to love like He loves, we must expect heart break because the consequences of a sinful world break His heart too. By allowing myself to really see people and feel a little of their pain I am able to better understand the heart of God, and am being molded closer to His image.

Heal my heart and make it clean

Open up my eyes to the things unseen

Show me how to love like You have loved me

Break my heart for what breaks Yours

Everything I am for Your kingdom’s cause

As I walk from earth into eternity

                                                                       Hillsong United - Hosanna
                               

        In the mist of heart break, however, I am reminded that the art of medicine is also individualistic. When I am with a patient all my focus is on that patient. We may not be able to heal an entire country, but we will change the lives of many individuals. I was reminded of this over the last few days as patients have come to the ship for their follow up surgical screenings, many of them hiding their deformity under a scarf because they are so used to being ostracized and looked down upon because of it, and I cannot wait until I can care for them and show them how much love the God who knitted them together has for His creation.  

In this the love of God was made manifest among us, that God sent his only son into the world, so that we might live through Him. In this is love, not that we have loved God but that he loved us and sent His son to be the propitiation for our sins. Beloved, if God so loved us, we also ought to love one another.                                                                                                

                                                                                                                             1 John 4:9-11

Prayer Points:

1.      The patients we turned away

2.      The surgeon screening process.

3.      The health of the patients leading up to surgery. That nothing would hinder, postpone, or cancel surgeries.

4.      For the hospital which opens September 11 and will perform its first surgery the next day.

5.      The spiritual protection for the Ship and all those aboard: patients, visitors, crew and day crew.

6.      For me. That God would continue to show me how to love those I’m serving and the strength to endure such a love.

Author's Note: While I am currently serving with Mercy Ships the ideas and opinions expressed here are my own. Mercy Ships has not reviewed nor do they endorse the content written within this blog. Thank you to the Mercy Ships Photographers who generously shared their pictures from the screening process.

We are in Benin, but What have We Been Doing Since Texas?

Praying for one of the workers at the township MISSION WHO counsels abused children

Why the Short Term Mission Trip?

In my last issue I told you all about my time at Mercy Ship’s headquarters in East Texas, completing an intense training termed “Onboarding”.  For the last two weeks of this training my onboarding group
(28 new long termers, 3 kids and 2 leaders) spent time in the Winterton area of South Africa for a field practice. The field practice seemed a strange concept at first. Why on earth does Mercy Ship ask its long term crew to basically participate in a short term mission trip before boarding the ship and settle into their long term positions? I don’t know every reason they do this, but let me share with you a little of my experience and what I learned during this process.

As I said above our field practice took place in the Winterton area of South Africa. We worked with two missionaries in 2 large Townships (slum areas) among the Zulu people. 80 percent of the people in this area are HIV positive. Many Zulu are practicing ancestor worshipers. These are among the poorest of the poor in South Africa. The lies of hopelessness, inferiority, and helplessness blanket the area with a fatalistic view of life. Sophie and Betsy (the women running the mission organizations in these Townships) are challenging this view, lights shinning in a dark world.

The plan was for our onboarding group to help with construction projects. One of the organizations had just acquired a plot of land and needed help building walkways, a fence, a playground, etc. We were then going to take turns participating in home visits to connect with and pray for local people; however, God sometimes has other plans. In my onboarding group there are four nurses and one physical therapist. Upon our arrival we discovered that the nurse at one of the missions had quit and left the day before and they had yet to find a replacement. So the home visits quickly turned into nurse visits. The mission was also ecstatic to find out about our physical therapist who ended up seeing many stroke patients in the area.

Our physical therapist making a huge impact by teaching a stroke patient’s wife how to wrap his foot so that he can walk without dragging his toes

The beautiful (hopefully destruction proof) playground made from old tires. I didn’t have much to do with this project, but our team was pretty proud of it. The kids were plenty excited too.

You would think that nurse visits would be in my comfort zone, after all that’s what I do. Right? Wrong! These visits were a struggle. Early on I felt very useless. We didn’t have anything to work with, remember we weren’t planning on doing any nursing. There wasn’t a whole lot that we could do, and I found this very frustrating. As the first week went on many of us in the group started voicing feelings of uselessness. Even our carpenter who was basically leading most of the construction projects voiced feelings of uselessness. Thankfully, someone noticed the pattern and brought it to the attention of the group. We realized that we were listening to a lie, that we were allowing the enemy to demean our time in Winterton. We decided as a group that we would not let that happen. We prayed together and we encouraged each other.

As a nurse I realized that I was providing the exact care that the mission had asked me to. They weren’t expecting me to fix chronic problems. They simply needed trained eyes on their patients. We were able to give them that peace of mind, and on two occasions because a nurse went on the visit, someone recognized the need to send the patient to a hospital. I also realized that I was so focused on the physical impact I was making, or lack thereof, I didn’t see the spiritual, emotional and relational impact I was making until I changed my mindset. One example of this was pointed out to me by the social worker I was riding with on our way to a new HIV patient’s home. The patient’s family worked for a white farmer and lived in a little community on the farmer’s land. If you are aware of South Africa’s history, you know about apartheid and the deep scars caused by segregation between the whites, blacks and mixed Africans. Relations between the races are slowly improving in many parts of South Africa, but in areas like Winterton the separation is still very noticeable due to the drastic difference in class status. The social worker told me that the very act of her black person driving me a white person around was “blowing people’s minds,” let alone that we were coming to visit with them in their homes.

Sifting Sand: Reflection of God’s Grace

I didn’t only do home visits.  I build a ramp! Ok I helped. Actually, I spent nearly an entire day sifting the sand we would need to make the cement for the wheelchair ramp we were constructing for an elderly handicapped couple while the carpenter and a couple of the guys demolished the dilapidated old structure and built the wooden frame that would allow us to pour the cement evenly.

The only sand available for sale was full of rocks, both big and small. When the nurse with me and I took one look at the mess I’m sure we were thinking the same thing. How are we ever going to turn this rocky mess into the fine sand required to create the smooth structure this couple needed for their walker and wheelchair?  Our first load of sand was damp and stuck to the cumbersome contraption we were using to sift. Each shovelful required gentle coaxing by rubbing the sand through with our hands. The dry sand was much easier, but even the dry sand had to go through the sifter multiple times. Every time we sifted the sand the rocks left behind became smaller, and the pile looked more and more of what we had envisioned, but we didn’t stop sifting until it was just right for its purpose. We had a plan. 

As we sifted I couldn’t help but compare our lives (my life) to the sand. I am full of rough edges and rocks, but God has a purpose for my life. He has a purpose for every life, and He is a patient sifter. Sometimes I am not ready to be sifted. I want to hold onto my sin and my flesh. I’m like sticky wet sand, but God doesn’t give up on me. He has a vision and has planned my purpose. He waits patiently for me, coaxing me until I become like dry sand, ready and willing to let go control, let go of burdens, let go of the rocks. Just as the sand is sifted many times, so to must I, but each time I become more like His image and ready for my purpose.

Sailing

As you are reading this we will have arrived in Benin. I will be starting orientation for my new job as a ward nurse while the screening team starts the process of finding the patients we can help; however, as I write this issue we are sailing. The hospital is not in service, and I am currently working in housekeeping, a hard but rewarding temporary job because I have quickly learned every inch of this ship.

We boarded the ship in Durban and sailed around the Cape, stopping briefly in Cape Town before continuing north along the west coast on our way to Benin.

I have decided that I really enjoy sailing (except for an unfortunate event that left me stuck in the crew galley for 30 minutes holding a standing freezer door closed and then paying for it later with a few hours of seasickness).

For most of the trip the sea has been calm, but we had one day when I awoke to what appeared to be an angry sea. The wind was causing the waves to fight our ship. We pitched and rolled more then we ever had before. The sea looked so huge and mighty. You could see God’s strength, His power, His glory, His justice, yet it was also an example of His mercy and grace because in the mist of the chaos and fury our little ship stayed afloat, and we were safe in His protection. It reminded me of two things. First, I deserve God’s wrath, His fury, His justice, but He instead offers His grace and provides a place of safety through His son. Secondly, when I stay within Him, keep my heart and mind steadfast on Him, He is my protection from the hardest storms and the deepest waters in this world.

Thank you for partnering with me in this journey. Your support in whatever way you have given it (financial, prayers, encouraging words) makes you as much a part of this mission as I am. I couldn’t be doing this without support. I am truly bless by you.

Prayer Points:

1.          Pray for the people in the Winterton area. That God’s light would shine and the     truth would be made known.

2.         That God would guide us as we start screenings and treat out first patients in Benin.

3.          That we would trust God to work through us and know how to minister to others cross culturally 

Author's Note: While I am currently serving with Mercy Ships the ideas and opinions expressed here are my own. Mercy Ships has not reviewed nor do they endorse the content written within this blog. 

Hello From East Texas

June – July Training at Mercy Ships’ Headquarters with the other Long termers. 

I am wrapping up a period of training (onboading) here at the Mercy Ships’ headquarters just outside Tyler Texas. The last few weeks have been a whirlwind. Mercy Ships is serious about sending long term crew who have the proper foundation and the tools to do their jobs with excellence. Week one we focused on Mercy Ships as an organization, their core values and why they do what they do.

Why Surgery?

Of all the things a hospital ship could do why does Mercy Ships focus on surgery? Answer: The inaccessibility of surgical intervention is the number one killer in the non-developed world. More people die due to the inaccessibility of surgery than AIDS, Tuberculosis and Malaria combined. 

Week two we studied Faith Foundations which went into depth about the character of God, our identity as children of God, prayer, and so on. At the end of the week we were dropped off at a State Park close by for a silent retreat. Of all the weeks week two was the most emotionally draining, but also the most empowering of our training. As I closed this week out with focused prayer I truly felt the Holy Spirit in ways I never had. Going into the week I was struggling with trusting God completely, but He gave me just what I needed through Mercy Ships, my small group leader, fellow onboarders, and His word for me to be able to give up control and just trust.

Week three we focused on community and ship life. Long term crew (myself included) make up about 150 of the 450ish crew onboard the Africa Mercy. Between 1000 - 1500 volunteers rotate through the Ship each year. The people who serve come from many walks of life (nationalities, denominations, cultures, ages, life experiences, etc.). We spent time learning about our own personality types, how we relate to others and how others relate to us. We also learned about the difference between “hot” and “cold” cultures, where miscommunications can happen and how to understand each other better.

Cultural Diversity

A Swiss, a Dutchie, a Yankee and a Texan went to the Rodeo. No I’m not starting a joke; that’s just what happened. Mercy Ship Volunteers come from all over the world. My onboarding group alone consist of 10 different nations. With time off over the weekend some of us were able to go into Fort Worth and experience Texan culture. We had a blast!

During week four we dug deep into the 3 major worldviews (animism, naturalism, and biblical theism). We were asked to look through the “glasses” others use to view the world so that we understand the core of their belief system. West African culture has a strong animism influence stemming from voodoo, meaning everything is spiritual. Looking at the world through animistic glasses is looking at the world through a fog of fear. In West Africa it is not uncommon for villages, families, even parents to push out individuals with deformities such as tumors, clubbed legs, clef lip/pallet, etc. because they view physical problems as a spiritual one. They fear that the individual is cursed or has angered a spirit. Imagine the isolation and shame the physically deformed in West Africa go through. This is one of the many reasons I am so excited to be serving with Mercy Ships, an organization dedicated to demonstrating the unconditional love of Christ, even to the most unlovable, those who are forgotten.

Week five we are focusing on safety. The non-hospital crew are taking a basic safety course complete with firefighting and lifeboat training. Hospital staff will receive evacuation training on board so I have most of the week off. 

What’s next?

We will be leaving Texas on July 13^th for South Africa to complete the last two weeks of our training. Mercy Ships understands that living and working within the ship community means that the ship has created its own unique culture, and Mercy Ships desires that its long term staff experience African Culture off ship before we minister to individuals in the context of the ships culture.

Our field practice will be in the town of Winterton South Africa, an area decimated by AIDS. 80% of the town’s inhabitants are HIV positive. We will be assisting in some construction projects as well as visiting houses, many of which are run by children because both parents have died of AIDS. 

We will board the Africa Mercy on July 28^th and set sail for Cotonou, Benin soon after where we will spend the next ten months.

Thank you for partnering with me in this journey. Your support in whatever way you have given it (financial, prayers, encouraging words) makes you as much a part of this mission as I am. I couldn’t be doing this without support. I am truly bless by you.

                   

Nicole Lukens

Prayer Points:

1.          Travel safety / jetlag / no delays

2.         Safety in Winterton (physical, spiritual and emotional)

3.          That we would trust God to work through us and know how to minister to others cross culturally

4.         No delays in setting sail for Benin

5.          Calm waters for the sail

6.         That we will arrive in Benin on time and ready for the service God has for us there

	Like all who work on Mercy Ships I am not paid for my service. I raise all my own support. If you would consider supporting me financially click here to go to my donor page. Thanks!